Low Cortisol levels

[Southmead]

Hello,

I’ve been steadily tapering back to 5 mg after a flare, currently on 7 mg of Pred, and I have been feeling pretty rough most days, the usual fatigue, stiffness, etc.

I had my annual physical, my doctor ordered blood test, I was surprised to see my CRP levels were all normal, as were all the other results. After my complaints they did another blood test for cortisol levels.

The range was 8 to 25. Mine was 5.9 basically much lower levels that the norm. Which I can only assume is why I’m not feeling good. They email me the results quickly here, and my doctor will have not seen them just yet. Does the team think these low levels of cortisol is causing me this discomfort?

Thank You

[DorsetLady PMRGCAuk volunteer]

Quite likely in respect of feelings of fatigue - have a look at this link re adrenals -

healthunlocked.com/pmrgcauk...

But stiffness could still be as a consequence of slightly too low a dose of Pred - despite the CRP being ‘normal’….

[Southmead in reply to DorsetLady]

Thanks, I had a feeling something wasn’t right, so at least the low cortisol levels explain something..

[SnazzyD]

As DL says low adrenal function could well be causing the fatigue and as someone who struggled to get my adrenal function back, it affects every bit of you. Don’t fret too much that your glands aren’t showing a great result as 5mg is still low enough to affect their functioning due to suppressing them. Further reductions (slow!) will keep telling the body it has to step up and make its own cortisol. If you are not rebounding as well as others it can make life a struggle which is a big disappointment when one is lead to think it’s all wonderful after the more potentially problematic higher doses. Poor adrenal function gave me general aches not specific areas of pain, so suspect a flare if those creep back. The link DL posted needs to be bedtime reading for all low dosers.

[Southmead in reply to SnazzyD]

Thank you..

[PMRpro Ambassador]

The cortisol was low because you are taking 7mg - which is plenty to suppress the natural production of cortisol - the body knows there is already plenty of corticosteroid present for it to function well and that too much is bad for it. So it doesn't make any more. Nothing more sinister than that.

The dose of pred you are on is about the same as the usual replacement therapy in adrenal insufficiency. It is possible that this is already low enough to make you feel fatigued but the option is to take more pred to feel better (maybe) but in doing that you go back a step in getting the adrenals to start producing cortisol at normal levels - the only trigger is there being very low levels of corticosteroid of any sort in the body.

[Southmead in reply to PMRpro]

As always thank you for explanation, makes sense.